An anal fissure which does not heal with conservative measures as sits baths and laxatives is a chronic anal fissure. Physiologically, it is the high resting tone of the internal anal sphincter that chiefly interferes with the healing process of these fissures. Until now, the gold standard treatment modality is surgery, either digital anal dilatation or lateral sphincterotomy. However, concerns have been raised about the incidence of faecal incontinence after surgery. Therefore, pharmacological means to treat chronic anal fissures have been explored. A Medline and pub med database search from 1986-2012 was conducted to perform a literature search for articles relating to the non-surgical treatment of chronic anal fissure. Pharmacological sphincterotomy using Glyceryl trinitrate , Isosorbide dinitrate or calcium channel blockers are exciting alternative treatment , that relaxes the anal sphincter and, therefore, promote healing, the drawback of such medications are headache and poor compliance. With the introduction of Botulinum toxin as mean of chemical sphincterotom, topical injection of Botulinum toxin reduces the anal hypertonia which lasts for few months, allows the fissure to heal, thus eliminating the need for surgery without incidence of incontinence. Cure rates are over 60%, and the procedure can be repeated safely. Therefore, Botulinum toxin is a reasonable first-line management of chronic anal fissure and the relapses can be managed by surgery Keywords: Non-surgical treatment of anal fissure, fissure in ano, sphicterotomy,botulinum toxin in anal fissures, glyceryl trinitrate. Chemical sphincteratomy, pharmacological sphincteratomy.
Stylistics represents a modern approach in understanding the literary text through the linguistic patterns that form it. The distinctive phenomena that the text includes constitute special features in it. As well as exploring its aesthetic aspects through description and analysis at the same time. The close link between stylistics and linguistics made stylistics occupy a prominent place in modern literary criticism.
In this regard, we do not want to dwell on the different directions of stylistics. Rather, we will prolong the discussion in the study of the style as a (deviation. Aversion) from the original. Because this trend plays on the chord of the paradox between the surface structure and the deep structure, especially when the sur
The advertising mail is considered as one of potential tools that followed to transfer the printed messages to the consumers and public customers whom are located at homes or works. This type of advertising is preferable due to the zero expense to receive the announcements of products, which became recently one of the successful procedures to create new customers and keep them in touch with direct communication. It is also possible to send them to specific group of people who can be classified by the advertisers to select even by name their own clients to give the personality to the clients for a long term of communication.
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... Show MoreThe research has been based on two main variables (information and communication technology) and the quality of blended education (physical and electronic), aiming to reveal the relationship between four dimensions (physical devices, software, databases, communication networks) and the elements of education represented by (the teacher, the student, the teaching process, curriculum). The methodology and post-analysis-based research were conducted at the Technical College of Management / Baghdad through polling the opinions of a random sample that included (80) teachers out of (86) and the number of students (276) representing a random sample from all departments of the college (for the morning study) out of (3500) stud
... Show MoreA mathematical model constructed to study the combined effects of the concentration and the thermodiffusion on the nanoparticles of a Jeffrey fluid with a magnetic field effect the process of containing waves in a three-dimensional rectangular porous medium canal. Using the HPM to solve the nonlinear and coupled partial differential equations. Numerical results were obtained for temperature distribution, nanoparticles concentration, velocity, pressure rise, pressure gradient, friction force and stream function. Through the graphs, it was found that the velocity of fluid rises with the increase of a mean rate of volume flow and a magnetic parameter, while the velocity goes down with the increasing a Darcy number and lateral walls. Also, t
... Show MoreObjective: To measure the serum levels of Fetuin-A, ischemia-modified albumin (IMA), and ferritin in hospitalized patients with severe COVID-19in Baghdad, Iraq. Moreover, to determine these biomarkers' cut-off valuesthat differentiate between severely ill patients and control subjects. Methods: This case-control study was done from 15 September to the end of December 2021 and involved a review of the files and collectionof blood samples from patients (n=45, group1) hospitalized in COVID-19 treatment centersbecause of severe symptoms compared tohealthy subjects as controls (n=44, group2). Results: Fetuin-A serum levels were not statistically different between patients and controls. In contrast, IMA and ferritin levels were significan
... Show MoreThis study aim to identify the concept of web based information systems since its one of the important topics that is usually omitted by our organizations, in addition to, designing a web based information system in order to manage the customers data of Al- Rasheed bank, as a unified information system that is specialized to the banking deals of the customers with the bank, and providing a suggested model to apply the virtual private network as a tool that is to protect the transmitted data through the web based information system.
This study is considered important because it deals with one of the vital topics nowadays, namely: how to make it possible to use a distributed informat
... Show More‘Ode to a Nightingale’(1819) is a typical poem of a Romantic poet like John Keats, but
‘The Nightingale’(1798) is an uncharacteristic poem of a Romantic poet like Coleridge.
The paper proposes a comparison between Coleridge’s ‘The Nightingale’ and Keats’
‘Ode to a Nightingale’.Coleridge’s poem diverges from the Romantic norm; it carries some
characteristics new to Romantic poetry like the realistic and objective portrayals of nature and
the nightingale, while Keats’ poem adhere to the characteristics of Romantic poetry; it
portrays nature and the nightingale subjectively and unrealistically. Coleridge’s poem is very
much influenced by the scientific approaches to environment, and natural his
An in-depth experimental study of the matrix effect of antifreeze (ethylene glycol) and water contamination of engine oil through FT-IR spectroscopy. With a comparison of the percent by volume concentration of contaminated fresh 15W-40 engine oil, there appeared to be a noticeable reduction in the O–H stretching signal in the infrared spectrum when ethylene glycol based antifreeze was included as a contaminant. The contaminants of distilled water, a 50/50 mixture of water and commercial ethylene glycol antifreeze, and straight ethylene glycol antifreeze were compared and a signal reduction in the O–H stretch was clearly evident when glycol was present. Doubling the volume of the 50/50 mixture as compared to water alone still res
... Show MoreThis research aims to predict the value of the maximum daily loss that the fixed-return securities portfolio may suffer in Qatar National Bank - Syria, and for this purpose data were collected for risk factors that affect the value of the portfolio represented by the time structure of interest rates in the United States of America over the extended period Between 2017 and 2018, in addition to data related to the composition of the bonds portfolio of Qatar National Bank of Syria in 2017, And then employing Monte Carlo simulation models to predict the maximum loss that may be exposed to this portfolio in the future. The results of the Monte Carlo simulation showed the possibility of decreasing the value at risk in the future due to the dec
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